Nokea
Which of the following is an example of multimorbidity?
- A. Chronic obstructive pulmonary disease and a urinary tract infection
- B. Lung cancer and pneumonia
- C. Chronic kidney disease and appendicitis
- D. Diabetes and exacerbation of rheumatoid arthritis
Correct Answer: D
Rationale: Multimorbidity means chronic twins diabetes and rheumatoid arthritis flare together, a dual load, not acute add-ons like UTIs, pneumonia, or appendicitis. Those flare fast and fade; chronic pairs grind on, tangled or not, a nurse's radar for complex care, a hallmark of long-haul illness overlap.
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Which of the following conditions/abnormalities is always present in people who are diagnosed with metabolic syndrome?
- A. Type 2 diabetes mellitus
- B. Disturbed renal function
- C. Hypertension
- D. Insulin resistance
Correct Answer: D
Rationale: Metabolic syndrome's core insulin resistance ties the knot, not always diabetes, kidney flops, or high BP. A chronic root nurses peg this constant.
An HIV-positive patient presents to the ED complaining of shortness of breath and non-productive cough. Chest x-ray shows diffuse interstitial infiltrates, and O2 saturation is 85% on room air. All of the following statements regarding this patient's probable diagnosis are TRUE, EXCEPT
- A. Pneumocystis carinii pneumonia (PCP) is the most common opportunistic infection in AIDS patients
- B. Pentamidine isothionate is an effective alternate therapy to TMP-SMX
- C. A normal chest x-ray rules out acute PCP infection
- D. 65% of patients relapse within 18 months
Correct Answer: H
Rationale: PCP top AIDS bug, pentamidine swaps TMP-SMX, relapse hits, steroids for hypoxia; normal CXR misses 20%. Nurses nix this chronic x-ray lie.
Percutaneous cervical cordotomy:
- A. Is performed under general anaesthesia.
- B. Occurs by entry of a needle into the intervertebral foramen between cervical vertebrae C4 and C5.
- C. Involves thermoablation of the anterior spinothalamic tract.
- D. Is performed on the same side as the pain.
Correct Answer: C
Rationale: Percutaneous cervical cordotomy (PCC) relieves cancer pain via targeted nerve destruction. It's done under local anesthesia with sedation, not general, to monitor patient response (e.g., pain relief, side effects) during stimulation. The needle enters at C1-C2, not C4-C5, targeting the lateral spinothalamic tract contralateral to the pain not the anterior tract explicitly, though terminology varies. Thermoablation destroys pain fibers, confirmed by test stimulation. It's performed opposite the pain side due to crossed spinothalamic pathways. Complete numbness isn't typical; sensory loss is partial. Thermoablation's specificity using radiofrequency to interrupt pain transmission defines PCC's efficacy, minimizing damage to adjacent motor tracts while achieving analgesia.
Which complications are the three main consequences of leukemia?
- A. Bone deformities, spherocytosis and infection.
- B. Anemia, infection, and bleeding tendencies.
- C. Lymphocytopoiesis, growth delays, and hirsutism.
- D. Polycythemia, decreased clotting time, and infection.
Correct Answer: B
Rationale: Leukemia, a bone marrow cancer, replaces normal marrow elements with immature, dysfunctional white blood cells (lymphoblasts), leading to three primary complications: anemia, infection, and bleeding tendencies. Anemia results from reduced red blood cell production, causing fatigue and pallor. Infection risk rises due to neutropenia immature lymphoblasts lack infection-fighting ability making children prone to severe illnesses. Bleeding tendencies occur from thrombocytopenia, low platelet counts causing bruising or petechiae. Bone deformities and spherocytosis aren't leukemia hallmarks; the former might occur in bone cancers like osteosarcoma, and the latter is a red cell disorder. Lymphocytopoiesis is a process, not a complication, while growth delays and hirsutism aren't primary leukemia effects. Polycythemia (high red cells) and decreased clotting time oppose leukemia's anemia and bleeding risks. Nurses must monitor these complications, as they guide interventions like transfusions or antibiotics, critical for supporting children through leukemia treatment.
A nurse is caring for a client recently diagnosed with pericarditis. Which of the following is a common assessment finding with this disorder?
- A. Elevated troponin
- B. Pericardial friction rub
- C. Heart failure
- D. ST-segment depression
Correct Answer: B
Rationale: Pericarditis rubs the sac pericardial friction rub, a scratchy sound, marks inflammation, a common find as layers grate. Troponin rises with muscle damage, not here. Heart failure or ST depression hints tamponade or ischemia, not direct. Nurses auscultate this rub, tying it to pericarditis's irritated core, a diagnostic bellwether.